Biomechanical Basis of Mild Traumatic Brain Injury

描述（由申请人提供）：运动相关的轻度创伤性脑损伤（MTBI或脑震荡）是一个重要的公共卫生问题，因为这些损伤的发生率高，受伤者相对年轻，可能长期残疾，重复发生累积效应的危险，以及无效的预防策略。我们建议开发和验证头部碰撞加速度的定量模型，以促进新的临床和治疗技术的转化研究和开发，以减少MTBI的发病率和负面影响。团队成员之间的实验、临床和产品开发项目将允许对MTBI的潜在病理力学和临床后遗症进行假设驱动的研究。对脑震荡的病理力学研究至关重要的是获得实际的头部加速度和由于冲击而暴露。头部撞击遥测系统（HIT System）技术此前已被开发并验证，用于在现场测量头部撞击加速度。这项技术将首次使闭合性头部损伤患者的生物力学、临床和神经心理学数据的前瞻性研究成为可能，从而可以直接测量损伤参数及其临床后果。在大学橄榄球运动员和男女大学曲棍球运动员的研究人群中，本提案的三个具体目标是：1)改进HIT系统，用于大规模记录、存储和检索现场头部碰撞加速度数据；2)使用HIT系统量化头部碰撞加速度，以检验MTBI损伤的冲击容限假设，以及累积冲击或性别是否会影响这些容限；3)将头部碰撞加速度与与MTBI相关的临床变量关联起来，通过使用经过验证的边线和临床工具（包括标准化边线评估、神经心理测试和功能磁共振成像），验证相对于匹配的对照组，头部加速度增加会增加脑震荡球员短期脑损伤测量的假设。这些研究的结果将为实现长期目标提供科学基础，以制定和部署新的策略，以提高MTBI的检测、预防、降低发病率和改善治疗。

DESCRIPTION (provided by applicant): Sports-related mild traumatic brain injury (MTBI or concussion) is an important public health problem because of the high incidence of these injuries, the relative youth of those being injured with possible long term disability, the danger of cumulative effects from repeat incidences, and ineffective strategies for prevention. We propose to develop and validate a quantitative model of head impact acceleration that enables translational research and development of new clinical and therapeutic techniques to reduce the incidence and negative effects of MTBI. Experimental, clinical and product development projects among team members will allow hypothesis-driven research specific to the underlying pathomechanics and clinical sequelae of MTBI. Crucial to the study of the pathomechanics of concussion is the acquisition of actual head accelerations and exposures due to impact. Head Impact Telemetry System (HIT System) technology was previously developed and validated for measuring head impact accelerations in the field. This technology will, for the first time, enable prospective studies of biomechanical, clinical, and neuropsychological data in human subjects with closed head injury, allowing for direct measurement of injury parameters and their clinical consequences. Within a study population of collegiate football players and male and female collegiate hockey players, the three specific aims of this proposal are: 1) improve HIT system for large-scale recording, storage, and retrieval of on-field head impact acceleration data, 2) quantify head impact acceleration using HIT system to test hypotheses on the impact tolerance to MTBI injury and whether cumulative impacts or gender influence these tolerances, and 3) correlate head impact acceleration with clinical variables related to MTBI to test the hypothesis that increased head acceleration increases short-term measures of brain injury for concussed players relative to matched controls using validated sideline and clinical tools including standardized sideline assessments, neuropsychological testing, and fMRI. The results of these studies will provide the scientific basis for achieving long-term goals to develop and deploy novel strategies to improve detection, prevention, reduce the incidence, and improve treatment of MTBI.